NPIMap

Organization Active NPI

Equitas Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Columbus, OH
National Provider Identifier
1972097707
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
EQUITAS HEALTH, INC
Practice address
750 E Long St
Columbus, OH 43203-1846
Phone
(833) 378-4827
Fax
(833) 222-8164
NPI assigned
Jun 15, 2018
Last updated
Apr 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Susan C Willis
Title
Payer Credentialing Manager
Phone
(833) 378-4827

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

750 E Long St
Columbus, OH 43203-1846

Mailing address

1105 Schrock Rd Ste 400
Columbus, OH 43229-1174
Phone (833) 378-4827

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120830000276 OH Part B Supplier - Clinic/Group Practice 2769638154 Receives reassigned benefits from 59 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Columbus, OH; Toledo, OH; Portsmouth, OH; Dayton, OH; Cincinnati, OH; Athens, OH; Akron, OH
O20180927002139 OH Part A Provider - Federally Qualified Health Center (FQHC) 2769638154 Practice locations: Columbus, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972097707. Details of each certification follow.

Federally qualified health center certification: CCN 361183

Legal name
EQUITAS HEALTH,INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 27, 2018
Last certification
Sep 27, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 26, 1984 in OH
Enrollment address
750 E Long St
Columbus, OH 43203-1846

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

750 E Long St
Ste 3000
Columbus, OH 43203
Phone (614) 340-6700

7575 Huntington Park Dr
#200
Columbus, OH 43235

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Karen Jean Shepherd Individual Corporate DirectorDirector of Revenue Jul 1, 2022
Susan Willis Individual Operational/Managerial ControlPayer Credentialing Manager Jul 10, 2023
Gene Holloway Individual Corporate DirectorProgram Director Jul 24, 2023

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Equitas Health,IncToledo, OH, CCN D21059 Federally qualified health center Operational/Managerial Control Apr 1, 2024

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775174400000",
    "number": "1972097707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SCHROCK RD STE 400",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432291174",
            "telephone_number": "833-378-4827",
            "fax_number": "833-222-8164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E LONG ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432031846",
            "telephone_number": "833-378-4827",
            "fax_number": "833-222-8164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUITAS HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-15",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PAYER CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "833-378-4827"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.